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US-based interests push enforced circumcision agenda

James Edwards | 22.12.2006 11:30 | Health | Repression | Social Struggles | World

In a concerted and well resourced media campaign, circumcision enthusiasts based in the United States have attempted to dupe us all into believing that male circumcision is a magic bullet for HIV prevention. Whatever your own view on circumcision, this campaign for enforced surgery crosses lines of ethics and consent that are fundamental for personal freedom.

++Background++
Male circumcision is a common routine procedure for newborn infants in the United States of America, regardless of their parents' religion. In Europe, particularly in Scandinavia, and in most parts of Asia, male circumcision is uncommon, being performed only as part of religious practice or because of a serious medical problem.

Evidence on the impact of circumcision upon a man's sex life is mixed. Whilst many men who have been circumcised as adults profess benefits as a result, it is likely that these men were circumcised because of a medical problem which could have tainted their pre-circumcision sexual experiences. It is also likely that men who have not found the operation beneficial will be too shy or embarrassed to say so.

A 2002 study published in the Journal of Urology found that, following circumcision for a medical problem, 50% of men reported improvement to sexual function. 38% of men reported harm to sexual function and 12% reported no change.
+For more information see  http://www.norm-uk.org/?169

Additionally, many intact or ‘uncircumcised’ men are enthusiastic about the sexual benefits of their status.
+See  http://www.norm-uk.org/what_intact_men_say.html

++The Campaign++
* If you’ve missed the story about the Ugandan HIV/Circumcision study you can read it here -  http://news.bbc.co.uk/1/hi/health/6176209.stm
* Most worryingly, the central campaign has been augmented by a series of circumcision advocates publicly suggesting that an enforced global circumcision programme should be directed at those least likely to benefit, and least able to defend themselves: baby and infant boys.
* Enthusiasts have suggested that infants should be circumcised, not just in Africa, but across the world, including in Asia and Europe. In the UK, a Scottish urologist who is a known advocate has inexplicably demanded that infant circumcision be paid for by the cash-strapped NHS.
* Infants simply aren’t vulnerable to contracting diseases through sexual intercourse, and won’t be until they become sexually active in at least ten years. By this time, cures or vaccines could be available, and even if they aren’t, the young adult can then choose circumcision for themselves, if it really has been proven as an effective measure.
* Other, more sinister interests must be behind this. It could perhaps be described as a “project for a new circumcised century”.

++Motivation of circumcision enthusiasts++
* Financial - The American Academy of Paediatrics (AAP) quotes an estimated total cost for circumcision as $US150-270 million in the US each year. Many of the companies benefiting from this are active worldwide and would benefit substantially from a worldwide increase in demand. (+see  http://www.circumstitions.com/$$$.html )
* Religious - People are of course free to exercise the beliefs of their chosen religion; however we all know that there are plenty of religious zealots who like to impose their agenda on the rest of us in whatever way they can, regardless of our faith.
* Financial 2 - Amputated foreskins are sold to middlemen who then package them for sale to research companies. Human body parts, especially from the very young, are considered gold mines for pharmaceutical development. (+see  http://www.norm-uk.org/where_do_foreskins_go.html )
* Sexual - a number of groups exist that profess a sexual interest in circumcision. In 2003 police investigating a paedophile in Scotland found photographs depicting the circumcision of a young boy amongst his collection. (+see  http://news.bbc.co.uk/1/hi/scotland/3227734.stm )
* Personal – Some men who have been circumcised like to insist that circumcision is a good thing. Some take this further by, for example, having their own children circumcised without any medical need. It is conceivable that there are men who wish to see the whole world circumcised in their image.
* For more information see the links at  http://www.norm-uk.org/circumcision_why.html

++Issues with the Ugandan study itself, and the likelihood of success in controlling the HIV epidemic in Africa++
* The number of infections as a proportion of the survey group is very small. Some 5000 men participated; half were circumcised and half were not. Of the group only 70-80 contracted HIV, about 25 from the circumcised group and 50 from the intact group. In other words, 1% of circumcised men contracted HIV whereas 2% of intact men contracted the disease.
* The survey was concluded early, allegedly for “ethical reasons”. Studies that are stopped early have a tendency to over-estimate the efficacy of the intervention. Offering circumcision to the intact group precludes collection of more reliable data.
* The premise for the survey is ethically dubious. If all the men in the study had been given condoms and ensured that they used them not one would have contracted HIV.
* Mass circumcision will undermine, and take money from, efforts to promote fidelity and condom usage, the two strategies that can protect people from infection all the time, not just (if we accept the results of the study) half the time.
* Witch doctors, barbers and other traditional healers in Africa will see an opportunity to make money by performing unsafe and unhygienic operations which will often result in complications and injuries as well as directly transmitting the HIV virus.

++Statistics around the world++
(+see  https://www.cia.gov/cia/publications/factbook/rankorder/2155rank.html )
The HIV/AIDS adult prevalence rate around the world, as published by the CIA, does not match a pattern that supports circumcision as an effective preventative measure. In the United States, where at least 60% of men have been circumcised, the figure (0.6) is three times that of the UK (0.2), where, at most, 20% of men have been circumcised. If circumcision is a universally effective preventative measure, then these figures should be reversed.

Moreover, why do other countries/regions where circumcision is known to be rare, such as Sweden, Japan, Norway, Hong Kong, Germany, Hungary and Croatia, appear close to the bottom of the prevalence list? Should these men not be more at risk than those in the equally 'western' and 'developed' but largely circumcised USA which has six times their prevalence rate?

++Statements from medical and ethical bodies++
The British Medical Association (BMA) -
(from  http://www.bma.org.uk/ap.nsf/Content/malecircumcision2006 )
"Unnecessarily invasive procedures should not be used where alternative, less invasive techniques, are equally efficient and available. It is important that doctors keep up to date and ensure that any decisions to undertake an invasive procedure are based on the best available evidence. Therefore, to circumcise for therapeutic reasons where medical research has shown other techniques to be at least as effective and less invasive would be unethical and inappropriate."
"Circumcision of male babies and children at the request of their parents is an increasingly controversial area and strongly opposing views about circumcision are found within society and within the BMA’s membership. The medical evidence about its health impact is equivocal."

The United Nations -
The Convention [on the Rights of the Child] establishes the right to “protection from all forms of physical or mental violence, injury or abuse, neglect or negligent treatment, maltreatment or exploitation, including sexual abuse"

++Fundamental ethical and consent Issues++
* Circumcision does not prevent HIV infection; it merely (assuming the studies are to be believed) lessens the chances of contracting the virus during unprotected sex. To be explicit about this, a man would only need to have unprotected sex a second time with an infected partner to face the same odds of contracting the virus.
* Any surgery causes irreversible damage to healthy tissue, and always carries a risk of complications, even when performed in the best possible conditions.
* Circumcision is an irreversible surgical operation.
* Governments and health corporations have no business imposing surgery on individual citizens without their fully informed and freely given consent.
* The male penis is a sensitive sexual organ, which does not come into full use until a boy reaches maturity and becomes sexually active.
* A child who has not reached sexual maturity cannot be expected to fully understand the purpose and workings of his genitals and is therefore incapable of giving fully informed consent. Moreover, a child is unable to contract diseases through sexual activity which he is physically incapable of participating in.

++Therefore++
* Any decision to circumcise a man on the basis of protection from the HIV virus needs to be made freely by the man himself, without coercion, and after he has been presented with a full an unadulterated set of information that reflects the uncertainty of success, the risks of surgery, the risks of sexual dysfunction, the relative effectiveness of other measures (such as condom use), and the irreversible nature of the operation.
* There is absolutely no basis for circumcising a child to prevent HIV infection until he reaches an age when he is both capable of, and likely to, engage in unprotected penetrative sex.

++Beyond male circumcision++
Acceptance of this measure by the public at large could pave the way for further enforced surgical procedures on the pretext of public health or other concerns.

Top of the list is likely to be female genitalia, as this contains similar 'langerhans cells' that are said to be susceptible to HIV under the male foreskin. Amputation of the female clitoral foreskin, where these cells are present, is less severe than the most common traditional female genital mutilation (FGM) practices and could be viewed as a directly equivalent measure to male circumcision.

Another possible scheme is the surgical implantation of Radio Frequency ID (RFID) chips. This might be sold to the public as a way to protect children, who would grow up accepting both the concept and reality of a tracking device inside them.

And what if the spread of the H5N1 bird flu could, for example, be slowed by surgically sealing the nostrils, because cells in the sinuses were especially susceptible to infection?

++Do something++
This is not about whether circumcision is a good or bad thing; the available evidence on that shows a mixed picture. Neither is this about the HIV epidemic in Africa, which will only be controlled by improving education, condom provision, fidelity and genuine healthcare. Magic bullets don’t exist; and this one is a con.

This is about the individual’s right to exercise complete control over pre-emptive surgical modifications to themselves. Don’t let it slip away.

Suggestions –
* Copy and distribute this article.
* Talk to your friends about this article.
* Visit and read information on the websites listed for your country below
* Lobby political figures and corporate media outlets.
* Lobby healthcare providers, HIV organisations and influential NGOs.

++Organisations and Websites++
(Listing of sites below is not intended to imply a specific endorsement, and aside from the country grouping, order is random)
UK –  http://www.norm-uk.org/
UK –  http://www.forwarduk.org.uk/
UK –  http://www.stop-mutilating-children.org.uk/
US –  http://www.mgmbill.org/
US -  http://www.icgi.org/
US -  http://www.cirp.org/
US -  http://www.doctorsopposingcircumcision.org/
US -  http://www.jewsagainstcircumcision.org/
US -  http://www.nocirc.org/
US -  http://www.noharmm.org/
New Zealand –  http://www.circumstitions.com/
France (in French/Francais and English) -  http://www.enfant.org/
Germany (in German/Deutsch)–  http://members.aol.com/Pillcock/
Israel (in Hebrew) -  http://www.britmila.org.il/
South Africa -  http://www.norm-sa.co.za/
Canada (in English and French/Francais) -  http://www.courtchallenge.com/
Denmark (in Danish) -  http://www.drengeomskaering.dk/
Turkey (in Turkish) -  http://www.geocities.com/tabibler/

James Edwards

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